Therapeutic alliance in the treatment of adolescent substance misuse: a systematic review

IF 6.8 3区医学 Q1 PEDIATRICS Child and Adolescent Mental Health Pub Date : 2023-08-01 DOI:10.1111/camh.12671

Iniyah Sulaman, Samantha Hartley, Rachel Elvins

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Abstract

Background

Therapeutic alliance has been found to play an influential role in predicting outcomes for adults and adolescents in psychotherapy. However, thus far, the information concerning the impact of therapeutic alliance on outcomes for adolescents in treatment for substance misuse has not yet been critically synthesised.

Methods

In accordance with PRISMA guidelines, the current review aimed to systematically collate published research investigating the association between alliance and outcomes for adolescents undergoing substance misuse treatment. Database searching produced 1083 records, with 16 studies meeting eligibility criteria.

Results

Twelve out of the 16 studies (75%) reported significant alliance–outcome relationships, whereby higher alliance ratings predicted better treatment outcomes, as well as improved engagement and retention in treatment. In addition, the review explored the conditions whereby alliances better predict outcomes, with reference to the alliance rater, the timing of the alliance rating and comorbid diagnoses. These results, however, largely remain inconclusive.

Conclusions

The evidence as it stands demonstrates the importance of the therapeutic alliance in predicting outcomes for adolescents in substance misuse treatments. The implications of the review's findings and recommendations for future research are discussed.

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青少年药物滥用治疗中的治疗联盟：系统回顾。

背景：研究发现，治疗联盟在预测成人和青少年的心理治疗结果方面发挥着重要作用。然而，迄今为止，有关治疗联盟对青少年药物滥用治疗结果的影响的信息尚未得到批判性的综合：根据 PRISMA 指南，本综述旨在系统整理已发表的、调查治疗联盟与青少年药物滥用治疗结果之间关系的研究。在数据库中搜索到 1083 条记录，其中 16 项研究符合资格标准：结果：16 项研究中有 12 项（75%）报告了联盟与治疗结果之间的重要关系，即联盟评级越高，治疗结果越好，参与度和治疗保持率也越高。此外，综述还探讨了在哪些条件下联盟能更好地预测结果，包括联盟评分者、联盟评分的时间以及合并诊断。然而，这些结果在很大程度上仍未得出结论：现有证据表明，治疗联盟在预测青少年药物滥用治疗结果方面非常重要。本文讨论了综述结果的意义以及对未来研究的建议。

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来源期刊

Child and Adolescent Mental Health PEDIATRICS-PSYCHIATRY

CiteScore

8.30

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.